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. 2025 May 2;4(6):101759. doi: 10.1016/j.jacadv.2025.101759

Table 3.

CMR Thresholds for TR Grading Proposed in Selected Prospective Studies of TR Patients

First Author Year Study Type Patient
Population
Primary Endpoint N Follow-Up CMR Criteria for TR Volume (mL)
(With aHR)
CMR Criteria for TR Fraction (%)
(With aHR)
CMR Details
Zhan et al 2020 Prospective cohort Functional TR 5-y all-cause mortality 547 Median 2.6 y Low: <30 (reference)
Intermediate: 30-44 (1.46)
High: 345 (2.26)
Low: <30 (reference)
Intermediate: 30-49 (1.21)
High: 350 (2.60)
Steady-state free-precession
Wang et al 2021 Prospective cohort Isolated severe TR 10-y all-cause mortality 262 Mean 2.5 y Low: <30
High: 330
HR per 5 mL increase 1.05 (95% CI: 1.02-1.08)
Minimal: <25
Low: 26-36
Intermediate: 37-49
High: 350
HR per 5% increase 1.13 (95% CI: 1.06-1.21)
Steady-state free-precession
Seo et al 2023 Prospective cohort Patients with HFrEF 3-y: A composite of all-cause death and hospitalization for HF 262 Median 921 d Low: 10 (reference)
Intermediate: 10-30 (2.11 [95% CI: 1.15-3.89])
High: >30 (7.16 [95% CI: 3.33-15.41])
Low: ≤15 (reference)
Intermediate: 16-30 (2.26 [95% CI: 1.14-4.51])
High: >30 (4.23 [95% CI: 2.22-8.04])
Steady-state free-precession
Hinojar et al 2021 Prospective cohort Patients with significant TR 5-y: A composite of hospital admission due to right heart failure and cardiovascular mortality 75 Median 3 y Low: <42 (reference)
High: >42 (HR 2.89)
TR volume per 1 mL aHR: 1.06 (95% CI: 1.03-1.08)
Low: <40 (reference)
High: >40 (HR 4.04)
TR fraction per 1% aHR: 1.02 (95% CI: 1.01-1.03)
Steady-state free-precession

aHR = adjusted HR; CMR = cardiac magnetic resonance; HF = heart failure; HFrEF = heart failure with reduced ejection fraction; TR = tricuspid regurgitation.